Isolated dislocation of the scaphoid

CASE REPORT A 39-year-old fire officer was travelling in a fire tender which overturned. The patient sustained a minor head injury, but his most important injury was to his left wrist joint. On attending the accident and emergency department he was noted to have a painful left wrist with an abnormal mass prominent on the volar radial aspect of the wrist. There was no neurological deficit in the left hand, but movement of the wrist was grossly restricted by pain. Radiographs of the wrist revealed a closed isolated, dislocation of the scaphoid (Fig. 1). Open reduction of the dislocation was performed under general anaesthesia. A radial incision revealed the dislocated scaphoid lying between the radial neurovascular bundle and the tendons of abductor pollicis longus and extensor pollicis brevis (Fig. 2). The radioscaphoid ligament was ruptured in its middle part and the scapholunate ligament was also ruptured.